Preliminary experience with 2-octylcyanoacrylate in a pediatric emergency department

Objective: Documentation of use of octylcyanoacrylate adhesives in a pediatric emergency department with reference to patient selection, complications, and parent satisfaction. Design: Retrospective and concurrent chart review of the fast 100 patients on which 2-octylcyanoacrylate (2-OCA, Dermabond®) was used in a pediatric emergency department. Additional telephone follow-up was performed for each patient. Results: The average patient age was 4.7 years, average laceration size 1.2 cm. Sixteen percent of wounds were repaired with 2-OCA. Three immediate complications involved a minor dehiscence and two eyelid adhesions. Two wound infections and a patient with hematoma and keloid formation were identified as later complications. The vast majority of parents preferred tissue adhesive repair to sutures. Time in department was reduced from 106 minutes to 69 minutes on average (P < 0.0001, CI 26-52). Conclusions: Octylcyanoacrylate adhesives performed well in the daily practice of a pediatric emergency department, ands were used for a significant percentage of laceration closures. Convenience, average infection rates, and good parental satisfaction make tissue adhesives a valuable addition to our wound closure techniques. Certain pitfalls occurring during early experience with these adhesives can be recognized and avoided.